Annals of emergency medicine
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Comparative Study
Experimental tricyclic antidepressant toxicity: a randomized, controlled comparison of hypertonic saline solution, sodium bicarbonate, and hyperventilation.
We sought to compare the effects of hypertonic sodium chloride solution (HTS), sodium bicarbonate solution, and hyperventilation (HV) on severe tricyclic antidepressant (TCA) toxicity in a swine model. ⋯ In this model of TCA, toxicity HTS was more effective than sodium bicarbonate. Hyperventilation had little effect. Sodium loading may be the most important factor in reversing TCA toxicity.
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Namibia is a sparsely populated nation in southwest Africa. A state-run health service provides care to most of the population. The geography and population distribution dictate the delivery systems for prehospital and emergency care. ⋯ The private prehospital care/transport systems are well organized and sophisticated. Formal efforts should be undertaken to develop ties with our colleagues in Namibia. Potential areas for collaboration include injury surveillance and prevention, field trauma resuscitation, and prehospital care.
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Comparative Study
Indicators of assault-related injuries among women presenting to the emergency department.
We sought to determine whether women presenting for treatment of assault-related injuries at a public hospital emergency department differed from those presenting for unintentional injuries with regard to a variety of demographic and presentation characteristics, nature and anatomic site of injury, and admission or follow-up treatment for injury. ⋯ Women identified as presenting with assault-related injuries differ from those who present with unintentional injuries in terms of their demographic and presentation characteristics, as well as the nature, anatomic site of injury, and follow-up treatment for injuries. Although some of this information has implications for service delivery to abused women, the use of clinical indicators such as nature and anatomic site of injury have limited predictive value. Therefore we recommend that health care providers routinely screen patients for assault, particularly assault by intimate partners, so that they may respond appropriately by providing better treatment and referral.
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A description of recent developments in emergency medicine and prehospital care in the new South Africa is detailed. As South Africa creates a new integrated health care system with equal access for all citizens, expansion of emergency care services to previously disadvantaged populations is occurring. To illustrate current disparities, a comparison of 2 regional systems of emergency medicine is included. The challenges involved and possible future directions in this effort are discussed.